Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M25/00—Catheters; Hollow probes
  • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
  • A61M25/09—Guide wires
  • A61M25/09041—Mechanisms for insertion of guide wires
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M25/00—Catheters; Hollow probes
  • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M25/00—Catheters; Hollow probes
  • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
  • A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M25/00—Catheters; Hollow probes
  • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
  • A61M25/09—Guide wires
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M25/00—Catheters; Hollow probes
  • A61M2025/0004—Catheters; Hollow probes having two or more concentrically arranged tubes for forming a concentric catheter system
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M25/00—Catheters; Hollow probes
  • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
  • A61M25/06—Body-piercing guide needles or the like
  • A61M25/0662—Guide tubes
  • A61M2025/0681—Systems with catheter and outer tubing, e.g. sheath, sleeve or guide tube
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M25/00—Catheters; Hollow probes
  • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
  • A61M25/09—Guide wires
  • A61M2025/09175—Guide wires having specific characteristics at the distal tip

Definitions

• the present invention relates to a guidewire system for insertion into human blood vessels for treatment and diagnostic procedures, and more particularly relates to multiple concentric wires in the guidewire system for maneuvering through bends, bifurcations, narrowing vessels, and other complications within the human blood vessels.
• Summary The invented guidewire system provides for inserting and maneuvering a guidewire for deployment of a treatment device within a human blood vessel.
• guidewires are inserted percutaneously into a relatively large artery or vein in one of the patient's legs.
• the wire may then be maneuvered upwards toward the heart, or contralaterally across the iliac bifurcation to gain access to the patient's other leg.
• the iliac bifurcation is one example of many bends and intersections within the human blood vessel system that present difficulties in maneuvering the forward tip of the wire to allow the wire to reach the desired location.
• the present invention provides two, three, or more hollow, concentric wires, coupled together for insertion into the human blood vessel with each wire having one or more attributes selected for use in maneuvering across the bends and intersections between the site of insertion and the location for investigation and treatment.
• each of the wires may be made hydrophilic to an extent selected among various degrees, and/or made stiff to a selected degree, provided with hydrophilic and stiff sections, and be transitionless or have transitions between the hydrophilic and stiff sections.
• the multiple wires may have independently selected attributes different from one another so that each may be beneficially used in maneuvering across the different types of bends and intersections and along blood vessels of varying sizes to reach the treatment or diagnostic site.
• a treatment or diagnostic device may be provided on one or more of the wires, typically adjacent the distal tip, including devices providing laser or radiofrequency energy, or optical coherent reflectometry (OCR).
• Fig. 1 is a cross-sectional side view of a guidewire system according to an embodiment of the present invention showing three concentric wires, including their proximal and distal ends, central lumens, and proximal handles.
• Fig. 2 is a cross-sectional side view of a guidewire system according to an embodiment of the present invention showing two concentric wires, and showing a treatment/diagnostic device at the distal tip of the inner wire.
• Figs. 1 is a cross-sectional side view of a guidewire system according to an embodiment of the present invention showing three concentric wires, including their proximal and distal ends, central lumens, and proximal handles.
• Fig. 2 is a cross-sectional side view of a guidewire system according to an embodiment of the present invention showing two concentric wires,
• 3A and 3B are a cross sectional view of two guidewires extending around a bend adjacent a bifurcation in a human blood vessel, showing the difference in performance between a transitionless wire (3A) and a wire with a transition (3B).
• Fig. 4 is a cross sectional view, from a perspective of facing the patient, of contralateral access by the guidewire from the right iliac artery to the left iliac artery.
• Fig. 5 is a cross sectional view of a two-wire guidewire system being maneuvered into a branch of a blood vessel.
• Fig. 6 is a cross sectional view of a two-wire guidewire system with catheter being maneuvered into a branch of a blood vessel.
• System 10 may include an inner wire 12 having a distal end 14 and a proximal end 16.
• Inner wire 12 has a length that may be selected for a particular type of procedure to be conducted in a human blood vessel, e.g., between about 180- cm and about 300-cm.
• Inner wire 12 may include an opening 18 adjacent distal end 14 and an opening 20 adjacent proximal end 16, and a central lumen 22 extending between the proximal and distal openings.
• Central lumen 22 defines an inner diameter for wire 12, and wire 12 also has a generally cylindrical outer surface 24 defining an outer diameter.
• the outer diameter of inner wire 12 is between about 0.004 and 0.014 inches, and may be any size therebetween, or larger or smaller as selected for the desired procedure and for compatibility with other wires, catheters, sheaths, and other equipment.
• Inner wire 12 is preferably provided with a handle 50, preferably removable, adjacent proximal end 16 that the physician may use in manipulating the wire about and along a central axis A of the wire.
• Preferably wire 12 is constructed with a hydrophilic material selected for the particular procedure. For example, coating with Teflon or plastic covering makes a wire hydrophilic.
• Wire 12 is preferably constructed without transitions between sections, if it includes any sections, of the wire.
• Inner wire 12 may be used in crossing a bifurcation in the human blood vessel, and may be provided with a rigidity selected to allow the bifurcation crossing. Rigidity is typically controlled by the use of braiding or the selection of various materials. For example, nitinol is flexible, but it becomes stiffer as more stainless steel is added. As best seen in Fig. 2, inner wire 12 may optionally include a treatment or a diagnostic device 52, typically located at the distal end 14 of wire 12. Alternatively, device 52 may be located in a more proximal position on wire 12, or may be located on the other wires or catheter to be described below.
• Device 52 may be any type of device useful for treating or diagnosing conditions in blood vessels, such as a radio-frequency energy device, a laser energy device, an optical coherent reflectometry (OCR) device, an ultrasound device, or any other device suitable for mounting on a wire or catheter and for controlling from outside the body while inserted in the body.
• a central lumen 32 of wire 26 extends between a distal opening 34 and a proximal opening 36. Central lumen 32 of second wire 26 defines an inner diameter for the wire.
• Wire 26 typically has a generally cylindrical outer surface 38 defining an outer diameter.
• wire 26 is between about 0.008 and 0.035 inches, and may be any size therebetween, or larger or smaller as selected for the desired procedure and for compatibility with other wires, catheters, sheaths, and other equipment.
• Wire 26 is preferably provided with a handle 54, preferably removable, adjacent proximal end 30 that the physician may use in manipulating the wire about and along a central axis A of the wire.
• second wire 26 has a rigidity selected to be greater than that of inner wire 12, thus providing the system with an overall variable rigidity which depends on the extent to which the inner wire extends out of the second wire.
• System 10 may also include a third or outer wire 40, as shown in Fig.
• third wire 40 is sized to fit over the second wire and includes a handle 56, preferably removable, coupled adjacent the proximal end for manipulation of the third wire about and along central axis A.
• third wire 40 has a rigidity selected to be greater than the rigidity of the first wire and greater than the rigidity of the second wire, thus providing the system with an overall variable rigidity which depends on the extent to which the inner wire extends out of the second wire, and the extent to which the second wire extends out of the third wire.
• Third wire 40 preferably has an outer diameter between about 0.010- inches and about 0.035-inches, and may be any size therebetween, or larger or smaller as selected for the desired procedure and for compatibility with other wires, catheters, sheaths, and other equipment.
• the length of the third wire is less than the length of the second wire, and the length of the second wire is less than that of the inner wire.
• the multiple guidewire system may be combined with a catheter, such as catheter 58 as shown in Fig. 6, that can be inserted over the wires.
• a catheter may include a balloon and a stent placement apparatus.
• the catheter or one or more of the wires may be provided with a radio- frequency energy device, a laser energy device, and/or an optical reflectometry device for applying treatment within the blood vessel, or with other devices, including diagnostic devices such as ultrasound.
• any of the handles of the first, second, and third wires may be used to manipulate all three wires, and also the wires may be manipulated relative to one another by simultaneous use of two or three of the handles.
• handles 50 and 54 may include one or more forward- facing wings 60, which interlock with corresponding notches 62 in handles 54 and 56, when the handles are pushed together.
• the length of the first wire is between about 180-cm and about 300-cm, but may be other sizes as desired for particular procedures.
• the length of the second wire is about 5-cm less than the first wire
• the length of the third wire is about 5-cm less than the second wire.
• Fig. 3A shows the performance of a transitionless wire, which can extend around the corner without doubling over
• Fig. 3B shows the performance of a wire with a transition, which tends to double over.
• the transition typically occurs where two materials that are different in hydrophilicity or stiffness are directly joined, and a transitionless wire is typically provided by gradually changing the hydrophilicity or stiffness, or by other methods of preventing the abrupt transition.
• Fig. 4 shows contralateral access by the guidewire system from the right iliac artery R to the left iliac artery L.
• Fig. 5 shows a two- wire guidewire system, including inner wire 12 and outer wire 26, and treatment/diagnostic device 52, being maneuvered into a branch of a blood vessel.

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• Health & Medical Sciences (AREA)
• Life Sciences & Earth Sciences (AREA)
• Biophysics (AREA)
• Pulmonology (AREA)
• Engineering & Computer Science (AREA)
• Anesthesiology (AREA)
• Biomedical Technology (AREA)
• Heart & Thoracic Surgery (AREA)
• Hematology (AREA)
• Animal Behavior & Ethology (AREA)
• General Health & Medical Sciences (AREA)
• Public Health (AREA)
• Veterinary Medicine (AREA)
• Media Introduction/Drainage Providing Device (AREA)

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Publications (3)

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• 2004
  • 2004-08-25 US US10/927,340 patent/US7402141B2/en not_active Expired - Lifetime
  • 2004-08-26 WO PCT/US2004/027892 patent/WO2005021062A2/en not_active Ceased
  • 2004-08-26 EP EP04782386A patent/EP1660152B1/de not_active Expired - Lifetime
  • 2004-08-26 AT AT04782386T patent/ATE530217T1/de not_active IP Right Cessation

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